US20050203549A1
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US
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Methods and apparatus for off pump aortic valve replacement with a valve prosthesis
Assignee: Individual
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Filing: 2005-03-09
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Granted: —
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Expires: 2025-03-09
Abstract
Abstract Methods and apparatus are provided for valve repair or replacement. In one embodiment, the method comprises providing an apparatus having a valve prosthesis, a valve leaflet support and a valve excisor, the apparatus having a first configuration and a second configuration; accessing the aortic root without placing the patient on a heart-lung machine; advancing the apparatus in the first configuration where the valve leaflet support is advanced through a valve, wherein the support is positioned below a valve annulus; expanding the apparatus into a second configuration so that the support will engage the valve; and moving the valve leaflet support and valve excisor together to remove leaflets of the valve. Penetrating members may be advanced into the tissue wherein the penetrating members may act as fasteners to hold the prosthesis in place.
Inventors
- 👤 Fidel Realyvasquez
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 05:18
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/11; A61B17/32; A61B17/320016; A61B17/3205; A61B17/32053; A61F; A61F2/00; A61F2/02; A61F2/04; A61F2/06; A61F2/064; A61F2/24; A61F2/2427; A61B17/115; A61B17/1155; A61B2017/00743; A61B2017/00778; A61B2017/00783; A61B2017/00831; A61B2017/00862; A61B2017/00867; A61B2017/00969; A61B17/064; A61B2017/0649; A61B2017/1107; A61B2017/1157; A61B17/22; A61B2017/22097; A61B2017/320064
Claims Analysis
Total Claims: 44
Claim 1
Independent Claim
137 words
1 . A method of valve replacement, the method comprising: providing a valve excisor; providing an apparatus having a valve prosthesis and a valve leaflet support, said apparatus having a first configuration and a second configuration; accessing the aortic root without placing the patient on a heart-lung machine; advancing the apparatus in the first configuration where the valve leaflet support is advanced through a valve, wherein the support is positioned below a valve annulus; expanding said apparatus into a second configuration so that said support will engage said valve; moving said valve leaflet support and valve excisor together to remove leaflets of the valve; advancing penetrating members on said apparatus into valve tissue, said penetrating members being secured in said valve tissue and a valve prosthesis, and act as fasteners to hold said valve prosthesis in position.
Claim 2
Dependent Claim
137 words
1 . A method of valve replacement, the method comprising: providing a valve excisor; providing an apparatus having a valve prosthesis and a valve leaflet support, said apparatus having a first configuration and a second configuration; accessing the aortic root without placing the patient on a heart-lung machine; advancing the apparatus in the first configuration where the valve leaflet support is advanced through a valve, wherein the support is positioned below a valve annulus; expanding said apparatus into a second configuration so that said support will engage said valve; moving said valve leaflet support and valve excisor together to remove leaflets of the valve; advancing penetrating members on said apparatus into valve tissue, said penetrating members being secured in said valve tissue and a valve prosthesis, and act as fasteners to hold said valve prosthesis in position.
Claim 3
Dependent Claim
28 words
2 . The method of claim 1 wherein accessing the aortic root without placing the patient on a heart-lung machine further comprises attaching a graft to the aorta.
Claim 4
Dependent Claim
77 words
3 . The method of claim 1 wherein accessing the aortic root without placing the patient on a heart-lung machine further comprises: attaching a first graft to the aorta; clamping said first graft; attaching a second graft to the first graft, wherein the second graft includes a hemostatic cap on a proximal end to prevent excessive blood loss and said apparatus contained in the second graft, said apparatus movable out of said graft and into the aorta.
Claim 5
Dependent Claim
21 words
4 . The method of claim 2 wherein said graft is compressed in an accordian-like fashion when the apparatus is advanced.
Claim 6
Dependent Claim
27 words
5 . The method of claim 1 wherein said apparatus further comprises using a ratchet to move the valve support to engage it against said valve leaflets.
Claim 7
Dependent Claim
35 words
6 . The method of claim 3 wherein said apparatus further comprises using a ratchet to move the valve support to engage it against said valve leaflets, said ratchet extending outward from the hemostatic cap.
Claim 8
Dependent Claim
18 words
7 . The method of claim 1 further comprising injecting the patient with medication to cause temporary asystole.
Claim 9
Dependent Claim
15 words
8 . The method of claim 1 further comprising injecting the patient with adenosine phosphate.
Claim 10
Dependent Claim
30 words
9 . The method of claim 1 further comprising using a pericardial tent on said apparatus to shield leaflets on the valve prosthesis from being damaged by the cutting element.
Claim 11
Dependent Claim
23 words
10 . The method of claim 1 wherein the valve excisor is turned with simultaneous proximal counter traction to remove the valve leaflets.
Claim 12
Dependent Claim
21 words
11 . The method of claim 1 wherein the valve leaflets are captured between the pericardial tent and the cutting element.
Claim 13
Dependent Claim
14 words
12 . The method of claim 1 wherein the apparatus is delivered minimally invasively.
Claim 14
Dependent Claim
23 words
13 . The method of claim 1 wherein attaching comprises delivering a shape memory clip that holds the valve prosthesis to the tissue.
Claim 15
Dependent Claim
92 words
14 . A valve delivery device comprising: a heart valve prosthesis support having a proximal portion and a distal portion; a plurality of fasteners ejectably mounted on the support; a heart valve prosthesis being releasably coupled to said distal portion of said heart valve prosthesis support; said heart valve prosthesis and support being configured for delivery to the heart through an aortotomy formed in the patient's aorta; a valve excisor; and an anvil movable along a longitudinal axis of the device to engage tissue disposed between the anvil and the valve prosthesis.
Claim 16
Dependent Claim
92 words
14 . A valve delivery device comprising: a heart valve prosthesis support having a proximal portion and a distal portion; a plurality of fasteners ejectably mounted on the support; a heart valve prosthesis being releasably coupled to said distal portion of said heart valve prosthesis support; said heart valve prosthesis and support being configured for delivery to the heart through an aortotomy formed in the patient's aorta; a valve excisor; and an anvil movable along a longitudinal axis of the device to engage tissue disposed between the anvil and the valve prosthesis.
Claim 17
Dependent Claim
24 words
15 . The device of claim 14 further comprising a pericardial tent positioned to capture valve leaflets between the tent and the valve excisor.
Claim 18
Dependent Claim
110 words
16 . A valve delivery device comprising: a heart valve prosthesis support having a proximal portion and a distal portion; a plurality of fasteners ejectably mounted on the support; a heart valve prosthesis being releasably coupled to said distal portion of said heart valve prosthesis support; said heart valve prosthesis and support being configured for delivery to the heart through an aortotomy formed in the patient's aorta; a valve cutting element; a pericardial tent positioned to capture valve leaflets between the tent and the valve cutting element; and a leaflet support movable along a longitudinal axis of the device to engage tissue disposed between the support and the valve prosthesis.
Claim 19
Dependent Claim
110 words
16 . A valve delivery device comprising: a heart valve prosthesis support having a proximal portion and a distal portion; a plurality of fasteners ejectably mounted on the support; a heart valve prosthesis being releasably coupled to said distal portion of said heart valve prosthesis support; said heart valve prosthesis and support being configured for delivery to the heart through an aortotomy formed in the patient's aorta; a valve cutting element; a pericardial tent positioned to capture valve leaflets between the tent and the valve cutting element; and a leaflet support movable along a longitudinal axis of the device to engage tissue disposed between the support and the valve prosthesis.
Claim 20
Dependent Claim
107 words
17 . An end-to-side access device comprising: a first portion of a tissue clamp; a second portion of the tissue clamp, said second portion having a collapsed configuration and an expanded configuration; a tissue cutter; a hollow shaft; wherein the second portion may be delivered through said hollow shaft into the vessel to engage an inner surface of the wall of the vessel while the first portion engages an outer surface of the wall; wherein the tissue cutter is configured to cut the tissue engaged by the tissue clamp, said first portion and second portion slidable to remove tissue engaged between the tissue clamp from the vessel.
Claim 21
Dependent Claim
107 words
17 . An end-to-side access device comprising: a first portion of a tissue clamp; a second portion of the tissue clamp, said second portion having a collapsed configuration and an expanded configuration; a tissue cutter; a hollow shaft; wherein the second portion may be delivered through said hollow shaft into the vessel to engage an inner surface of the wall of the vessel while the first portion engages an outer surface of the wall; wherein the tissue cutter is configured to cut the tissue engaged by the tissue clamp, said first portion and second portion slidable to remove tissue engaged between the tissue clamp from the vessel.
Claim 22
Dependent Claim
18 words
18 . The device of claim 17 further comprising a graft housing said tissue cutter and tissue clamp.
Claim 23
Dependent Claim
21 words
19 . The device of claim 18 further comprising a ring of fasteners used to secure the graft to the tissue.
Claim 24
Dependent Claim
15 words
20 . The device of claim 18 further comprising a hemostatic cap on the graft.
Claim 25
Dependent Claim
91 words
21 . A device for use with a heart surgery device in an off-pump heart procedure, the device comprising: a blood containment device wherein one portion of the device is configured to be attached to a blood vessel while blood is flowing in the vessel; a hemostatic cap located on another portion of the blood containment device, wherein the hemostatic cap allows a portion of the heart device to extend through the hemostatic cap without creating a leak; and a vent allowing for air to be removed from the containment device.
Claim 26
Dependent Claim
91 words
21 . A device for use with a heart surgery device in an off-pump heart procedure, the device comprising: a blood containment device wherein one portion of the device is configured to be attached to a blood vessel while blood is flowing in the vessel; a hemostatic cap located on another portion of the blood containment device, wherein the hemostatic cap allows a portion of the heart device to extend through the hemostatic cap without creating a leak; and a vent allowing for air to be removed from the containment device.
Claim 27
Dependent Claim
27 words
22 . The device of claim 21 wherein the blood containment device is sized to house at least a portion of a valve prosthesis delivery device therein.
Claim 28
Dependent Claim
38 words
23 . The device of claim 21 further comprising a release device that allows the portion of the device with the hemostatic cap to be removed from the portion of the containment device attached to the blood vessel.
Claim 29
Dependent Claim
15 words
24 . The device of claim 21 wherein the blood containment device is a graft.
Claim 30
Dependent Claim
30 words
25 . The device of claim 21 wherein the blood containment device is a graft made of a pliable, flexible material that can be clamped to created a fluid seal.
Claim 31
Dependent Claim
30 words
26 . The device of claim 21 wherein the blood containment device is attached to the blood vessel without substantial blood leakage and without creating a life-threatening loss of blood.
Claim 32
Dependent Claim
22 words
27 . The device of claim 21 wherein the blood containment device houses a portion of a multi-fire valve prosthesis delivery device.
Claim 33
Dependent Claim
20 words
28 . The device of claim 21 wherein the blood containment device has a diameter of less then 30 mm.
Claim 34
Dependent Claim
20 words
29 . The device of claim 21 wherein the blood containment device has a diameter of less then 20 mm.
Claim 35
Dependent Claim
20 words
30 . The device of claim 21 wherein the blood containment device has a diameter of less then 10 mm.
Claim 36
Dependent Claim
24 words
31 . The device of claim 21 wherein the blood containment device is sized to fit inside a four inch incision into the sternum.
Claim 37
Dependent Claim
111 words
32 . A method of valve replacement, the method comprising: providing a valve prosthesis delivery apparatus; attaching a blood containment device to the aorta to prevent substantial loss of blood when the aorta is cut to provide access to an interior of the heart; cutting the aorta to access the aortic root without placing the patient on a heart-lung machine; advancing the apparatus to the area of the diseased valve; delivering the valve to the target site; retracing the valve prosthesis delivery apparatus into the blood containment device; and sealing off a portion of the containment device to allow the delivery device contained therein to be removed without significant blood loss.
Claim 38
Dependent Claim
111 words
32 . A method of valve replacement, the method comprising: providing a valve prosthesis delivery apparatus; attaching a blood containment device to the aorta to prevent substantial loss of blood when the aorta is cut to provide access to an interior of the heart; cutting the aorta to access the aortic root without placing the patient on a heart-lung machine; advancing the apparatus to the area of the diseased valve; delivering the valve to the target site; retracing the valve prosthesis delivery apparatus into the blood containment device; and sealing off a portion of the containment device to allow the delivery device contained therein to be removed without significant blood loss.
Claim 39
Dependent Claim
27 words
33 . The method of claim 32 wherein the blood containment device is sized to house at least a portion of a valve prosthesis delivery device therein.
Claim 40
Dependent Claim
37 words
34 . The method of claim 32 further comprising an release device that allows a portion of the device with a hemostatic cap to be removed from the portion of the containment device attached to the aorta.
Claim 41
Dependent Claim
15 words
35 . The method of claim 32 wherein the blood containment device is a graft.
Claim 42
Dependent Claim
30 words
36 . The method of claim 32 wherein the blood containment device is a graft made of a pliable, flexible material that can be clamped to created a fluid seal.
Claim 43
Dependent Claim
30 words
37 . The method of claim 32 wherein the blood containment device is attached to the blood vessel without substantial blood leakage and without creating a life-threatening loss of blood.
Claim 44
Dependent Claim
22 words
38 . The method of claim 32 wherein the blood containment device houses a portion of a multi-fire valve prosthesis delivery device.
References Cited (Backward Citations)
No citation records indexed.
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